I recognize that there are risks and hazards directly or inherently involved in the Activity and that I may become injured during my participation. With full knowledge of the facts and circumstances surrounding this Activity, I voluntarily undertake this Activity and assume all responsibility and risk from my participation in this Activity, including all risk of loss of limb or life, property damage, injury to others, and other hazards to me.

I assure officials of CCSU that I have adequate health insurance necessary to provide for and pay any medical costs that may directly or indirectly result from my participation in this Activity and that I will indemnify and hold CCSU and its employees and agents harmless.

I assure CCSU that there are no health-related reasons or problems that preclude or restrict my participation in this Activity.

I, for myself, my heirs, executors and assigns, hereby release CCSU and its employees and agents, from any liability whatsoever arising out of my participation in this Activity, including but not limited to, any damage to my property or the property of others and injury to me or to others, including loss of limb or life, resulting from my negligence or the negligence of others, or to others through my participation in this Activity.

The foregoing is submitted in consideration of CCSU allowing my participation in this Activity. I execute this document with full knowledge of the contents and consequences stated in this Entry Form & Release.